=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437606019
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAYAL RANA NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2016
-----------------------------------------------------
Last Update Date | 06/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9240 N MERIDIAN ST STE 120
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46260-1811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-571-0030
-----------------------------------------------------
Fax | 317-219-4690
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9240 N MERIDIAN ST STE 120
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46260-1811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-571-0030
-----------------------------------------------------
Fax | 317-219-4690
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 71013381A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------